Guide to Patient & Family Engagement
The Guide to Patient and Family Engagement
in Quality and Safety:
Engaging Patients and Families to Improve the
Quality and Safety of Care We Provide
| Barbara Vahle MSN, RN | May 20, 2014
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Today’s presentation is about….
• Improving the care we provide through patient and family
engagement
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Patient and family engagement:
Improving the care we provide
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What is patient and family engagement?
Patient and family engagement:
• Creates an environment where patients, families,
clinicians, and staff work together as partners to improve
the quality and safety of care
• Involves working with patients and family members as:
– Members of the health care team
– Advisors at the organizational level
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Patient- and family-centered care
• Patient and family engagement is an important part of
providing patient- and family-centered care
• Core concepts of patient- and family-centered care:
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Dignity and respect
Information sharing
Involvement
Collaboration
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Benefits of patient and family engagement
• Improves multiple aspects of hospital performance
– Overall improvements in quality and safety
• Patients and families as allies in safe medication use,
infection control initiatives, observing care processes,
reporting complications
• Reduction in preventable readmissions
– Improved patient outcomes
• Emotional health, symptom resolution, pain control,
physiologic measures
– Improved CAHPS® Hospital Survey scores
• Patient-provider communication, pain management,
medications, provision of discharge information
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Benefits of patient and family engagement
– Better response to the Joint Commission standards or
other accreditation
– Improved financial performance
• Decreased litigation and malpractice claims
• Lower costs per case due to complications
• Improved patient flow
• Less waste associated with higher call volume, repetitive
patient education efforts, diagnostic tests
– Enhanced market share and competitiveness
• Establishment of brand identify around patient and
family engagement
– Increased employee satisfaction and retention
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Benefits of patient and family engagement
• Patient and family engagement also:
– Is consistent with BRCN mission and vision :
To provide excellence in professional nursing and healthcare
career education.
– Is consistent with Blessing Hospital mission and vision :
“To improve the health of our community.”
– Helps us meet a strategic priority – Quality and Safety in
patient care
– Is the right thing to do
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The Guide to Patient
and Family Engagement
• What is it?
• What do we want to do?
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Guide to Patient and Family Engagement
• Tested, evidence-based resource to help agencies work as
partners with patients and families to improve quality and
safety.
– Includes strategies that reflect critical opportunities for
patient and family engagement
– Addresses real-world challenges
– Contains detailed implementation guidance
– Includes tools for hospital leaders, managers, clinicians,
patients, and families
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Guide to Patient and Family Engagement
• Includes four strategies to support engagement:
1. Working with Patients and Families as Advisors
2. Working with Patients and Families at the Bedside:
Communicating to Improve Quality
3. Working with Patients and Families at the Bedside:
Nurse Bedside Shift Report
4. Working with Patients and Families at the Bedside:
Care Transitions from Hospital to Home:
Discharge Planning
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Why work with patients and families as
advisors?
• Patient and family advisors help us provide care and
services based on patient- and family-identified needs
rather than our assumptions.
• Patient and family advisors offer:
– Insight on our strengths and areas where changes may be
needed
– Feedback on practices and policies that can help patients
and families be active partners in their care ….
– Feedback that is timely and gives a fuller picture of the
care experience than standard patient and family
satisfaction surveys
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Why focus on communication?
• It’s the foundation of all interactions with patients and families
• Research shows patient-centered communication can
improve:
– Patient safety
• More than 70% of adverse events caused by breakdowns in
communication
– Patient outcomes
• Including emotional health, functioning, and pain control
– Patient experiences of care
• Who do I go to for information or help?
• Who can provide a clearer understanding of how to ask
questions….and what to ask?
• How can I participate in my care?
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Why focus on bedside shift report?
• Transitions in care have potential for medical errors
• Research shows bedside shift report can improve:
– Patient safety and quality
• Improved communication
• Decrease in hospital-acquired complications
– Patient experiences of care
• Talk with me…..not about me…..
• Allow the patient to decide who their “family” is…
– Time management among and accountability between nurses
• Decrease in time needed for shift report
• Decrease in overshift time
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Why focus on discharge planning?
• Nearly 20% of patients experience an adverse event within a
month of discharge, of which ¾ could be prevented.
• Common complications post-discharge are adverse drug
events, healthcare-associated infections, and procedural
complications.
• Many complications can be attributed to problems with
discharge planning.
– Changes in medicines before and after discharge
– Inadequate preparation for patients and families
– Disconnect between information giving and patient
understanding
– Discontinuity between in-patient and out-patient providers
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Moving forward
• What do we need from you?
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What do we need from you?
• Nursing needs to take the lead ……
– Why nurses?
– Why not nurses?
• What barriers may be encountered?
Are we ready to give up some control?
Do we value patient input?
Are patients ready, willing , and appropriately informed
to make decisions about their health care?
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Other ways to support patient and family
engagement
• Communicate the vision and values related to patient and
family engagement.
• Serve as role models for engaging in partnerships with
patients and family members.
• Provide the necessary infrastructure and resources.
• Involve and support clinicians and staff in patient and
family engagement initiatives.
• Integrate patient and family engagement into personnel
policies and practices.
– Reassess visitor policies
– Assist family while in the hospital
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What nurses can do to promote patient and
family engagement…
• When patients question or want to check the medications
you are giving them….listen to them, welcome it!
• When family members comment….”I didn’t see you wash
your hands,” …..thank them for reminding you and do it!
• When family members ask about a test or
diagnosis…encourage their interest and value their input.
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What nurses can do to promote patient and
family engagement…
• Help family members move into a more active role in care…
– Provide information that is understood by them….clarify and
simplify the information.
– Explain reasons for medications, labs, diagnostic tests, NPO etc
– Value patient/family participation in care and decision
making…. help them transition into a more active role
– Remember that information is not enough….create reminders
and charts to help them with care…..I & O charts, NPO reminders,
turn/repositioning check lists, need for specimens, bedrest……
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What nurses can do to promote patient and
family engagement…….
• Encourage patient networking…patients with similar
problems know what other patients want and need to
know… (www.Patientslikeme.com …website of
information with 1500 diseases)
• Encourage patients to seek out information on their
diagnosis… Google is a start…..
• EHR (electronic health records) …online access to their
own records….currently used by the VA
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Better Patient Engagement…..
• Leads to higher HCAHPS scores
(Hospital Consumer Assessment of Healthcare
Providers and Systems)
• Leads to higher reimbursement….
outcomes of care are being measured and payments are
made based on HCAHPS scores
• Makes good business sense…..
• FOLLOW THE MONEY…..
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Better Patient Engagement…..
• Leads to happier more satisfied patients….
• Leads to increased patient involvement and accountability…
• Leads to happier more satisfied nurses….
• Leads to nurse retention…..
• Leads to safety and quality of care….
• It is the right thing to do….
• Leads to a WIN – WIN situation!
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Patient Engagement….let’s get started!
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Ten minute sit down….
Spirituality …..
Patient updates….
Educating the entire family….
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Thank you!
• For questions or more information:
Barb Vahle MSN, RN
Assistant Professor
Blessing-Rieman College of Nursing
vahleb@BRCN.edu
217-228-5520 ext:6912
• Agency for Healthcare Research and Quality:
Advancing Excellence in Health Care
www.ahrq.gov
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